Modern-day couples prefer to be prepared in advance for major milestones in their lives, be it exploring an alternate career choice, relocating, co-investment in a long-term asset like a home or planning to grow the family. Having a baby is often the biggest turning point in the family’s lifecycle – the joys of welcoming a new member to the family surpasses any other highpoint in life. And yet, it is almost always coupled with the anxiety of a potentially stressful pregnancy, being responsible for the infant’s wellbeing, and providing for the child during its formative years. Srinath Mukherji, Co-Founder, SANA Insurance Brokers Pvt. Ltd., says, “Each of these stages can be financially demanding, especially if there are unexpected medical complications involved. One method of mitigating the expenses related to pregnancy and childbirth would be to purchase an adequate maternity cover well in advance.”
Srinath shares reasons why you should consider maternity cover in health insurance before starting a family and also explains some nuances to bear in mind.
#1 Better Preparedness
Financial security is one of the main factors that couples mull over before having a baby. Ever-increasing costs related to maternity, childbirth and motherhood make it difficult for most salaried couples to manage the entire expenditure on their own. Besides, in the event of a challenging pregnancy or post-birth complications, the related medical expenses can be quite exorbitant. “Advance planning of buying add-on maternity cover in your prevailing base health insurance policy at a nominal additional premium will play a vital role in protecting the family’s finances as you won’t have to dip into your personal savings to fund the entire cost,” advises Srinath.
#2 Waiting Period
Maternity cover is typically extended as an add-on to base health insurance plans and carries a waiting period during which associated claims cannot be raised. “The waiting period is between 9 months to 4 years depending upon the insurer, although a few plans allow you to waive this off for extra premium. Moreover, an ongoing pregnancy is considered a pre-existing condition and is therefore excluded from coverage,” says Srinath.
If you already have an existing health policy, it would be wise to check the maternity waiting period and apply for the optional rider well in advance. This will ensure that the coverage can be availed when you are with child, after serving the stipulated waiting period. There are certain group health insurance schemes that extend maternity benefits from day one, although this may not always be the case by default. Should your corporate health cover not include maternity, the prudent thing to do would be to buy a personal health insurance plan along with the add-on maternity cover with the least waiting period.
#3 Coverage Inclusions
Considering the multiple medical interventions needed in pregnancy and childbirth, the ideal maternity cover should take care of pre- and postpartum care (such as regular doctor visits, screening and ultrasounds, etc.) along with delivery charges (whether normal delivery or C-section). “Note that not all maternity covers include all these expenses. Further, there could be certain sub-limits and conditions applied (for example, number of days for pre- and post-delivery care expenditure coverage, maximum amount for delivery charges, room rent or type capping). Reading the fine print carefully and having prior knowledge of nuances will help you evaluate the features against personal expectations,” says Srinath. In case of a mismatch, you can always consider porting your plan to an alternate insurer or increasing the maternity coverage amount if the option is available with your current insurance company.
#4 Coverage For The New Born
Health insurance nomenclature distinguishes between a ‘just born’ baby and a ‘new born’. “A just born infant could be covered under the mother’s maternity benefit automatically, though there could be a cap on the amount of coverage extended. Some insurers state this as up to the maternity sum insured while others specify a maximum amount. Thereafter, according to the number of days from birth as stated by the insurer (usually from 90 to 180 days), the new born would have to be included separately for health insurance coverage by informing the company and paying extra premium,” explains Srinath. The family would be better served knowing these details beforehand to validate sufficient coverage for the baby when it is needed the most.
#5 Maternity Exclusions
All health insurance plans that offer maternity cover carry a list of corresponding exclusions. Some of the common ones are self-decided abortion unless under medical advice, ectopic pregnancy, surrogacy, artificial fertilisation, etc. In recent times, a few insurance companies in India have designed maternity covers that cater to assisted reproduction technologies. Couples who are unable to conceive naturally would need such external medical interventions and should therefore explore investing early on in a plan that supports such treatment methods.
#6 Associated Terms
There are a number of other conditions which the family should be aware of ahead of time. For instance, certain insurance companies insist that the spouse has to necessarily be insured under the same family floater plan that covers maternity benefits for the stipulated time period. There may also be a ceiling on the number of deliveries permitted, which would particularly be of interest to couples who are planning on having more children. “Those who wish to have a baby at a later stage in life must cross-check the maximum age at entry for the mother-to-be (average 40 to 45 years). The family must also verify the list of network hospitals nearby, especially if the couple relocates to a different city during the gestation period,” says Srinath.
Also read: All You Need To Know About Ovulation Tracking For Pregnancy Planning